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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 565801748
Report Date: 01/24/2025
Date Signed: 01/24/2025 12:35:30 PM

Document Has Been Signed on 01/24/2025 12:35 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS N.ASC, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364
FACILITY NAME:SAILS LA LOMAFACILITY NUMBER:
565801748
ADMINISTRATOR/
DIRECTOR:		JAMIE CHAVEZ CALLEJASFACILITY TYPE:
735
ADDRESS:2065 ERBES RDTELEPHONE:
(805) 864-3733
CITY:THOUSAND OAKSSTATE: CAZIP CODE:
91362
CAPACITY: 4CENSUS: 4DATE:
01/24/2025
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:24 AM
MET WITH:Jamie CallejasTIME VISIT/
INSPECTION COMPLETED:
12:45 PM
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Licensing Program Analyst (LPA) Angela Barutyan arrived at the facility unannounced to conduct a required annual visit at 10:24AM. LPA met with House Lead Viking Valiente and explained the reason for the visit. Administrator Jamie Callejas arrived at 11:47AM.

Beginning at 10:27AM, the LPA, along with the House Lead toured the physical plant areas inside and outside to ensure there are no health and safety hazards. The following was observed.

KITCHEN/LAUNDRY/GARAGE: LPA toured the kitchen at 10:27AM. Kitchen appliances were clean and in operable condition. The facility has a sufficient supply of perishable and non-perishable food. Medications and knives were stored locked and inaccessible in a hallway closet by the entry. The laundry room in between the kitchen and garage contained additional supplies such as emergency food and extra non-perishable foods and locked and inaccessible cleaning solutions and detergents. The garage was observed unlocked and contained a locked and inaccessible cabinet with cleaning solutions/chemicals and an additional refrigerator and freezer.

BEDROOMS: The facility is a single-story residential home with four (4) bedrooms for private-use. LPA observed client bedrooms, which were furnished appropriately with clean linens, appropriate furnishings and sufficient lighting. Inside temperature was maintained at a comfortable level. There is no staff bedroom on premises.

RESTROOMS: The facility has three (3) restrooms. Client restroom were relatively clean and sanitary and in operating condition with slip-resistant materials. At 10:37AM, hot water measured at 105.4 degrees Fahrenheit, which is within the required range.
Report continued on LIC 809-C.
SUPERVISORS NAME: Kristin Heffernan
LICENSING EVALUATOR NAME: Angela Barutyan
LICENSING EVALUATOR SIGNATURE: DATE: 01/24/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/24/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS N.ASC, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364
FACILITY NAME: SAILS LA LOMA
FACILITY NUMBER: 565801748
VISIT DATE: 01/24/2025
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COMMON AREAS: The LPA observed common areas to be relatively clean and properly furnished. The LPA observed the fire extinguishers to be fully charged and last serviced on 01/11/2025. Required postings are posted throughout facility to promote handwashing, and cough/sneeze etiquette. At 10:44AM, smoke detector(s) and carbon monoxide detector were tested and were operational at the time of the visit.

OUTDOOR SPACE: At 10:41AM, the LPA observed the back patio which has a covered outdoor area for client use. Passageways were free and clear from obstruction. There are no bodies of water on the premises. Exit gate was observed to self-latch with difficulty.

MEDICATION REVIEW: At 10:46AM, LPA reviewed medications for all four (4) clients. Medications are centrally stored and locked in a closet by the entry. All medications including PRNs were labeled, stored, and locked inaccessible to residents. PRNs have physicians order on file. Medications are labeled and checked for expiration dates. Medications are properly documented on the centrally stored medications and destruction record. No errors observed during the medication review.

RECORD REVIEW: Beginning at 11:10AM, LPA reviewed four (4) out of four (4) client and four (4) personnel files for documents including but not limited to: medical records, care plans, Admission Agreement, TB test, health screening, staff training and fingerprint clearance. All client and personnel files were in order.

INFECTION CONTROL/EMERGENCY DISASTER PLANNING: During today's visit, LPA reviewed the facility's infection control policy as well as the emergency disaster plan. The facility’s policies and procedures as it pertains to infection control are adequate. Emergency disaster plan is updated annually as required. Emergency drills are conducted quarterly as is required, with the last drill conducted on 01/13/2025.



No deficiencies cited at this time. Exit interview conducted. A copy of the report was issued.
SUPERVISORS NAME: Kristin Heffernan
LICENSING EVALUATOR NAME: Angela Barutyan
LICENSING EVALUATOR SIGNATURE:

DATE: 01/24/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/24/2025
LIC809 (FAS) - (06/04)
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